Reports of multiple tick-borne diseases to Maine CDC are
indicating an increase in all tick-borne diseases. Physicians have already
reported more anaplasmosis cases so far this year than all of last year, and
babesiosis and Lyme numbers are steadily increasing as well. Providers should
be aware of the risk and prevalence of these diseases and consider them in
their diagnoses.
Anaplasmosis:
- 228 cases reported to date in
2016, compared to 186 in all of 2015
- 116 cases reported from the Mid
Coast region (Knox 49, Lincoln 43, Sagadahoc 18 and Waldo six)
Babesiosis:
- 49 cases have been reported to
date in 2016, compared to 55 in all of 2015
- 13 cases reported from York
county, ten cases from Knox county
Lyme disease:
- Lyme disease cases take several
months to be entered and classified, so current numbers are not available
at this time
Powassan:
- No cases have been reported to
date in 2016, compared to one in all of 2015
Co-infections:
Because all of these diseases are carried by the same tick
(Ixodes scapularis), a person may be infected with more than one disease.
- To date, 11 co-infections have
been reported: four co-infections with anaplasmosis and Lyme disease, two
co-infections with babesiosis and Lyme disease and five co-infections with
anaplasmosis and babesiosis.
- In 2015, 22 co-infections were
reported: ten co-infections of Lyme disease and anaplasmosis; eight
co-infections of Lyme disease and babesiosis; one co-infection of
anaplasmosis and babesiosis; one co-infection of Lyme disease,
anaplasmosis and babesiosis; one co-infection of Lyme disease and
ehrlichiosis; and one co-infection of babesiosis and ehrlichiosis.
Recommendations for Providers:
- Consider tick-borne illnesses
in your differential, particularly for individuals with “summer flu”
symptoms
- Submit samples for testing
- Treat patients appropriately –
recommendations for treatment are available from http://www.idsociety.org/uploadedfiles/idsa/guidelines-patient_care/pdf_library/lyme%20disease.pdf
- Report cases. All tick-borne
illnesses are reportable in Maine, including the erythema migrans rash
which is confirmatory. All cases should be reported by phone to 1-800-821-5821
or by fax to 1-800-293-7534.
For more information:
- Maine CDC vectorborne webpages:
http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/index.shtml
- Maine Physician’s Reference
Guide: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/documents/tick-reference-guide.pdf
- Lyme forms for providers: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/lyme/index.shtml#resourcephysicians
- Guidance on treatment: http://www.idsociety.org/uploadedfiles/idsa/guidelines-patient_care/pdf_library/lyme%20disease.pdf
- Lyme disease data: https://data.mainepublichealth.gov/tracking/home
